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Perthes, Long-Term Effects

‘Perthes is a childhood disorder which affects the head of the femur (the ball of the ball and socket joint of the hip). In Perthes disease the blood supply to the growth plate of the bone at the end of the femur (called the epiphysis) becomes inadequate. As a result the bone softens and breaks down (a process called necrosis). Over several months the blood vessels regrow, and the blood supply returns to the ‘dead’ bone tissue. New bone tissue is then laid down and the femoral head regrows and remodels over several years. This is similar to how bone reforms and remodels after any ‘normal’ fracture or break to a bone, but takes longer,’

(https://www.perthes.org.uk/what-is-perthes-disease/)
As this quote says Perthes is a childhood condition that affects the hip in growth. However, I often come across adults talking in various social media groups as if they still have Perthes and some even swear blind they still do have it. Technically no one can have it as an adult, but you can have the after effects of having had it as a child. The after effects for me where Justas bad as the Perthes itself.


Not everyone who has Perthes will go on to have such bad after effects; some will have very little at all. It is said that the younger someone has Perthes the better the chances of a full recovery with less side effects, particularly those aged under five. I was diagnosed aged seven and my hip never seemed to grow back fully in the right shape or size.


Pain and hip replacement


I almost always had some kind of pain coming from my hip area, be it the hip itself or the weak muscles. The pain did not go away after the Perthes was said to have run its course due to the damaged state the hip was left in. Not all Perthes patients carry on having pain like I did; it depends on how well the hip grows back to its proper shape. In a lot of cases the ball of the hip does not reshape to fit the socket well, which can lead to a faltered ball, creating significant problems later.


It is said that patients who had Perthes are at higher risk than most of having osteoarthritis, one study of sixty people with Perthes put it as high as over fifty pecent and often at a younger age than normal. I was told I was developing the early stages of osteoarthritis in my early twenties. This eventually led to me using crutches on a daily basis as weight bearing on the hip became too painful. Then aged twenty-five I had a total hip replacement.

According to a fairly recent study ‘LCP patients had a significantly higher risk of THR surgery compared to sex- and age-matched control persons’ (https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.92BSUPP_IV.0920594c)

After my hip replacement I had a lot less pain from the hip area, but my muscles were very weak from lack of use over many years. Once I started doing more with the leg the muscles became sore. Pain after Perthes is very common in muscles suddenly being used more than they are used to. I have found physiotherapy very helpful for strengthening my muscles again.


Leg length issues and posture


Leg length discrepancy is common amongst those who had Perthes due to bone growth not being complete or loss of height due to flattening of the head. Also, some surgeries such as femoral varus osteotomy can contribute to leg length discrepancy, making it a now less preferred treatment for some surgeons.


I had a 1.5 cm difference in leg length before my hip replacement which caused me to limp. A long term limp is not good for your posture. I ended up having posture related issues. I had back pain off and on since about the age of eleven, nothing server, but early signs the way I walked was not good. Then in my late teens I started to get neck and shoulder problems which gradually got worse, till one day aged twenty-four I woke up with a frozen shoulder, which took weeks to get back to fully functioning again and still has twinges now and then.


Physiotherapy has helped a lot with my posture issues. Initially several sessions of massage using ultra sound with the physio gave me great relief, followed by doing the exercises she gave me every single day. I still do some of those exercises years later. The exercises prevent my posture issues from getting even worse and help a lot with the pain.


During my hip replacement my surgeon made sure to correct my leg length difference as much as possible, this has almost removed my limp entirely (apart from when my hip muscles are very sore).


Another thing that can be done is to have an orthopaedic lift fitted to your shoes or an insole used for less server discrepancies. An orthopaedic specialist can advise on this.


It is important to make sure any walking aids such as sticks and crutches are the correct height as this can also be a contributing factor for posture issues. I feel that years of using a cane did not help my back, leaning to one side.


Fitness and fatigue


Due to pain when using my hip much before my replacement I had a poor level of fitness. When you struggle to even walk well it can make exercise tricky. Swimming was about the only proper exercise I found that was not too painful. It made recovery from my replacement surgery slower as not only were my leg muscles weak, but I had become used to not walking very far at all. I had to build up my fitness levels again. Physiotherapy, aqua fit classes and walking more helped with this.


Another reason I was so unfit was the fact that I was tired most of the time. Constant pain is exhausting. Pain can affect your sleep, making it hard to get comfortable and fall asleep. I found when very tired my hip hurt more, making it even harder to get to sleep. I was also on some strong pain medication which probably contributed to how tired I was feeling. Fatigue made getting much exercise and doing much at all hard work.


Surgery outcomes


According to my research it does not seem to make much difference if Perthes patients have surgery as a child or not long term. Recent studies are now showing that surgery seems to be a short term solution and that in fact some surgeries such as osteotomies can make later surgeries trickier. In a lot of cases it is hard to know if the hip would have grown back and recovered anyway given time as it sometimes does in those without any surgery.
http://www.harboursidephysiotherapy.co.uk/Injuries-Conditions/Hip/Research-Articles/Hip-Replacement-for-Adults-who-had-Perthes/a~4365/article.html

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AARGH!

Autistic Meltdowns

I suddenly start to yell at the people around me, getting increasingly loud.  I yell abuse, threats and swear.  I stamp my feet, bash the table and cry, sobbing loudly.  I look like a toddler having a tantrum, except that I am a full grown adult.

A tantrum is voluntary, used as a tool to manipulate and get your own way.  However I have no control at this point, there is no planned purpose or manipulation intended.  My emotions are at over load and crashing down like an avalanche.  I am having an autistic meltdown.

This describes my meltdowns at their worst, when I totally loose it.  Not all my meltdowns are at that level.  They vary in intensity and in how long they last.

What causes me to have a meltdown is not always easy to pinpoint.  It can be caused by a sudden change in plans or lack of knowing what the plans are.  If plans are made and I am expected to be part of those plans, but I am not informed in exact detail as to what those plans are in advance, it can cause me to get confused and upset.  Any kind of confusing situation can cause a meltdown if it continues being confusing for a significant length of time.  Frustrating situations such as people continuously not listening to me or things going wrong a lot can be a trigger.  Another trigger can be interrupting one of my OCD routines, when I am already somewhat stressed.  Fatigue can be a cause, when I am too tired to control myself any more.  Major disappointment has been a trigger in the past.  Sometimes a meltdown can be me having made such an effort to fit into a situation for hours that I eventually explode.  I will have kept back opinions, been polite to people who frustrate me and basically have been in a situation I find difficult for so long that in the end a meltdown is like a cathartic release.  Putting pressure on me to do something I have clearly already said no to is a big trigger and can cause me to feel like you do not respect me, no means no!

Often a meltdown may not be caused by one specific thing, but by a series of things that can build up over time.  It can take hours or days for the triggers to build up sometimes and one last thing can be the final straw.  I can sometimes work out why I had a meltdown afterwards, but often struggle to know at the time and sometimes never figure it out.  Asking me at the time why I am having a meltdown is not a good idea, often it just makes my meltdown worse, making me frustrated that I do not know why I am having it.

Sometimes I can feel myself getting increasingly annoyed and know I need to get away from the situation.  If I need to leave a room or walk away let me, it will be better for everyone.  However I can’t always feel it coming and it will happen like it or not. 

When I was younger I had more frequent meltdowns that often lasted longer than they do now.  I had them a lot as a teenager in school.  I think I was frustrated with life then, feeling trapped in a school that did not really meet my needs.  Being undiagnosed I was not getting the right support.     Also I am sure puberty played a part.

I still have meltdowns, but less often than I used to.  I feel maturity has helped a lot having had time for my hormones to settle down and time for me to get used to life as an adult.  I also feel my independence has helped me.  Since l got my own flat I feel more stable and able to manage my own life.  I am in charge of what do and when, making me less confused and frustrated.  I am also better at dealing with certain kinds of stressful situations.

When I do have a meltdown now I find I they do not last as long as they used to.  I can calm myself down more quickly and rationalise with myself somewhat about the situation.  Being angry at people who can do nothing to help is daft and will not get me anywhere.

Yoga breathing can help slightly to prevent a meltdown getting worse, but it depends on the exact situation.  It helps me to focus my mind on the breathing and think calmer thoughts. 

I hate that I still have meltdowns at all.  It makes me come across as immature and selfish.  It gives the wrong impression about me to other people, like I am just some angry, hate filled bitch.  Telling me to grow up or to stop being so over sensitive is unhelpful, if I could totally stop having meltdowns I would.

Phrases that almost always annoy me in some way

Reading Facebook comments I started to notice there are several phrases that almost always manage to get on my nervous and make me feel like that person is either a moron or not very nice.  I started to think about other expressions I also really dislike and why I do not like them so much.  This is what I came up with.

Cheer up love, it might never happen

What if ‘it’ already did happen?  What if that is my normal expression?  This phrase is often said to women by men, the kind of men who expect women to be smiley and bubbly all the time, which is almost impossible to be constantly.  My thinking face often gets this comment by total strangers passing me in the street, which I think is actually quite rude.  They do not know me or what I am going through at that moment.

Man up

To show emotions or feelings as a man is often seen as week or unmanly, but that is just a stereotype and it in no way makes you less of a man.   As a woman I find it more attractive when a man is able to show some emotions, it makes them not seems just cold, but whole and human.  Stereotyping men as always strong and tough means a lot of men do not admit when they need help and they can end up in serious situations with their mental health.

Just get over it

You cannot tell someone to just stop their own feelings.  To say it to someone can make them feel unheard and trivialised, as if you are dismissing how they feel.  It can make someone sound selfish and uncaring.  This is especially true in regards to mental health, a clinically depressed person cannot just get over it and I cannot just get over my OCD rituals that easily. 

I’m a bit OCD

OCD is not just being neat and arranging your music collection in alphabetical order, it is a serious mental health condition that can cause someone a great deal of stress and affect their ability to live their everyday life as they would wish.  You cannot be just a little bit OCD, you either meet the criteria to be diagnosed with it by a mental health professional or you do not.  The use of this phrase trivialises OCD and can prevent those really suffering from seeking help.

But you don’t look disabled

Some people seem to assume disabled people all use wheelchairs or at least some kind of walking aid and when they do not, act surprised when someone tells them they are disabled.  If someone considers their condition disables them, they are disabled, even if that condition does not require a walking aid.  Some people use this phrase when someone uses a disabled parking badge or disabled toilet but does not conform to their stereotype of disabled.  It is no one’s business why someone uses these facilities and people should not judge on appearances alone. 

What do you do?

In other words, how do you earn a living?  This can be an awkward question when you live on benefits and have not had paying work in some years.  When I tell people I sometimes get the rude eye role of ‘oh, you are one those lazy people who sponge off society’ or sometimes they just assume it must be because I am special needs, which, while that might sort of be partly true, they then often get rather patronising.  When some people ask I do not mind so much, but when someone I have only just met asks me or someone who really does not need to know, I can find it rather annoying.  It can help to say I volunteer, although some people do not respect volunteering and think it is an excuse to stay on benefits and not do ‘proper’ work.   

Young people today show no respect

This is a stupid expression since all age groups have some disrespectful people among them.  I have   seen elderly people disrespect the young just as much as I have seen the young disrespect them.  In fact even this expression is disrespectful as it makes out all the young are the same.  Respect is a two way street, are the elderly respecting the young in the first place? 

Special snowflakes

Young people often get called snowflakes now whenever they challenge an older person’s point of view or bring them up on their offensive behaviour such as racist jokes or use of derogatory expressions.  A special snowflake is used to describe a millennial that is seen as over sensitive, thinking the world revolves around them and that just moan about everything, but do not really care.  The current issue they are moaning about will not last; it will melt away and be replaced by a new one like a snowflake.  This is used to dismiss any younger person’s point of view by some and does not help a generation of young people already struggling to find their place in the world.  As Shelly Haslam-Ormerod says in online magazine The Conversation, ‘flippant stereotyping of a generation as weak based on their mental well-being contradicts efforts to reduce mental health stigma’.  As a millennial myself I find the term not only offensive, but used as a lazy argument or when an older person has clearly got no other defense for what they have said or done.

That’s so gay

Younger people often seem to use this expression now to mean something is bad, rubbish or stupid.  I am not sure how this came about, but it makes me uncomfortable.  It gives the word gay negative associations and I am sure the gay community does not need more negativity.       

Charity begins at home

Look after your own family and direct circle first, or in other words unless I have to come into direct contact with you regularly, I will not be offering you any help.  It is used as an excuse to not give any money or time to others by mostly quite selfish people.  I cannot see why I cannot care about both my family and friends and other wider causes at the same time, but this expression seems to be saying this is impossible to do, which is simply not true. 

I’m not racist, but…

Excuse me whilst I am actually racist.  If you feel you need to justify what you are about to say with this expression then do not say it or you simply are racist.  A truly non racist person would never need to make that statement in the first place.  

My experiences of therapy

I have tried various kinds of therapy for my mental health over many years, some though the NHS and some I have found for myself.  These are my experiences of the therapies I have tried.

Cogitative Behavioural Therapy (CBT)

‘CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle’, (www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/). 

It aims to break down problems into smaller more manageable parts.  You are shown how to change negative patterns to improve the way you feel.  Unlike other talking therapies it focuses on current problems rather than issues from your past.  It is most commonly used to treat anxiety and depression; hence I have had it for my OCD, which is a type of anxiety disorder.  

However it was not that well explained to me when I had it and seemed based on the idea that I could just stop and walk away from my OCD rituals, which if I could do that I would not be needing therapy in the first place.  The NHS website says each session should last thirty to sixty minuets, but after my initial session most of them did not last that long.  I was encouraged to take a lot of my therapy sessions by phone, which seemed to not be a very effective form of therapy for me. 

CBT does not address winder problems such as other mental health issues that could be impacting on your anxiety or depression.  I have since found out that CBT is often ineffective for people with autism, such as me, as it does not address the autistic side of things.  All CBT seemed to do for me was to get rid of one OCD ritual for it to be replaced with another.  I can see how this might help if you have a dangerous ritual, but otherwise seems a bit unhelpful.  I can see CBT might work for some who have not got more complex issues, but it was not for me.  However this seems to be the only therapy a lot of people can ever access on the NHS as if it is a panacea that will cure all mental health issues. 

Mindfulness

Mindfulness is a type of meditation that focuses on being present in the moment without judging anything. ‘A typical meditation consists of focusing your full attention on your breath as it flows in and out of your body. Focusing on each breath in this way allows you to observe your thoughts as they arise in your mind and, little by little, to let go of struggling with them. You come to realise that thoughts come and go of their own accord; that you are not your thoughts. You can watch as they appear in your mind, seemingly from thin air, and watch again as they disappear’, (http://franticworld.com/what-is-mindfulness/)

Mindfulness is about noticing what your body and mind are telling you, and then being able to react more calmly to things.  One exercise is a mindful body scan where you focus your attention slowly through the body one part at a time.  Tensing up and relaxing muscles as you go so you notice the difference between the two states.

Mindfulness can help problems such as anxiety, depression and stress.  Some mindfulness exercises are often used as part of other therapies and workshops.  I have found some of the exercises helpful as part of laughter yoga and drama therapy.  I find focusing on my breathing sometimes helps me to clear my mind and relax.  However I feel that the word mindfulness has been corrupted as a marketing term to sell stuff from colouring books to health food snacks, and I refuse to buy anything labelled as such.  

Counseling

Counseling encourages you to talk about your feelings and emotions with a trained therapist.  They can help you clarify issues, explore your options, develop strategies and increase self-awareness.  I had counseling at university and later through my GP surgery.  I found it slightly helpful at university as she gave me some strategies I could use, but the other counseling I had achieved nothing other than me talking about my issues and going round in circles.    

Anger Management

Anger management aims to help you understand why you are angry and find a healthier way to express yourself.  CBT is often used in anger management to help deal with negative thought patterns.

I had some anger management as a teenager, whilst the relaxation part helped a little bit; I feel I was not mature enough yet to put the techniques into practise properly.  I was also depressed off and on at the time which may have not helped me to make the most of it. 

Group Therapy

Group therapy is a form of psychotherapy in which one or more therapists treat a group of clients at the same time.  Some uses CBT or mindfulness.  Group therapy tends to be focused on one particular issue such as addiction meetings, a shared illness or mental health condition or a traumatic experience you may have in common.  Some groups use skills training as therapy such as art, drama or music.  Group therapy has several advantages such as knowing you are not alone with the shared experiences and feelings, sharing ideas and information and hope when you see others recovering.

I had some group therapy in my early teens which used activities and discussions to help us.  Whilst I feel I did benefit slightly from it, I feel that it was hard to make the most of it due to some of the group not really wanting to be there.  I also feel that some of the group could have been a bad influence on me had I been more vulnerable, trying to persuade me during the breaks to take up smoking for example.

Laughter Yoga

Laughter yoga is a group therapy based on the idea that laughter is healthy, both for the mind and body.  Exercises are done to create laughter, starting with forced laughter; it usually turns into real laughter.  It uses chanting, clapping and games to encourage a sense of playfulness.  It often uses elements of drama therapy and visualisation techniques.  Yogic breathing is done in-between laughter exercises, relaxing the mind and body.  At the end of each session laughter meditation is done using some elements of mindfulness. 

I first encountered laughter yoga about three years ago and then last summer I started attending a new weekly session run by a friend of mine in the town where I live.  It helps me to relax and de-stress.  It is not hard work and I find it great fun.  I can understand it might not be for everyone, you need to be fairly comfortable with letting yourself go in front of others, (my drama background maybe helpful in this).  However I highly recommend giving it a try as it is my favourite form of therapy I have tried.

Drama Therapy

Theatre techniques are used to help personal growth and mental well-being.  Drama therapy is often used in schools, prisons, hospitals and in work places to promote team building and healthy working relationships.  It involves role play, voice work, movement and storytelling.  It can help people explore personal and social issues.  It helps some people learn to express themselves better.  As part of my drama studies over many years I have done a few workshops using drama as therapy to explore various topics. I think workshops have great potential to help a lot of people, but it has to not be forced on people as some could be very uncomfortable with it and not everyone is able to do things like this in front of a group.  

Self Help Books and Online

Often I have found that self-help is more effective.  I have read a few books on autism and mental health and used various online message boards and chat rooms.  Also I have watched some documentaries on TV about my issues.  I have often learnt more about how to help myself from these things than any professional therapy I have had because I can pick and choose what elements to read and watch and do it in my own time.  I also feel less pressure to recover or learn a technique in a set time period.  Plus the ideas are not restricted to the NHS guidelines which often appear very strict and limiting.

Hobbies can also be a kind of therapy, for me writing is like that.  Writing my thoughts down is helpful, so I keep a daily diary.  Writing this blog often feels as satisfying as therapy.  Sharing my issues, anxieties and feelings often helps me.  A lot of people seem to find art therapeutic.   

I have found therapy is a very personal experience and what works for one person, maybe less effective for another, even with same diagnosis.  It is worth trying different therapies or even retrying one at different stages of your life.  What may have not helped as a teenager, maybe more effective when you are more mature and not forced into it by your parents.  Do not just rely on what a doctor can refer you for, but do your own research into what is on offer in your local area outside of official medical channels.  There are other kinds of therapy that I know less about that maybe worth looking into.  Sometimes people need a combination of therapy and medication which is perfectly valid, it does not mean therapy has failed if you also need medication.  Therapy also requires will power and wanting to learn from it, being ready to get well, forcing it will not work.

A Paperless Internet Soceity- are we pricing the poor out of modern life?

Last summer for about two weeks or so, I had major issues trying to get on the internet.  Trying to get technology to actually let me online was proving very tricky.  Firstly my mobile phone decided to stop working properly on Facebook, not allowing me to comment on anything or ‘like’ anything.  Slowly more and more Facebook functions died.  For someone who volunteers to help two local charities run their Facebook pages, this was a problem.  I knew I needed a new phone; it was about five years old and slowing down.  So I was using my local library computers, however they started to have their own issues.  Being networked when one computer goes wrong they all start to go wrong.  For most of the summer only about half the computers in the library worked and during this two week period, none decided to work at all.  So I went to use my laptop at my parent’s house, where I often go as they have Wi-Fi and I do not.  That was when my parent’s internet and my laptop stopped communicating.  So my mum said I could use her PC instead, but it was clearly not a fault with my laptop, as her computer could also not get any Wi-Fi signal.  For some reason my mum’s tablet could get online, so I managed a few of the more important tasks on that.  I managed to get my internet issues sorted out eventually, but it got me thinking about how so much of modern life relies on being able to get online. 

I love the internet; it helps me as an autistic person to communicate with others better and to feel connected to the world.  However I can see that it is becoming an issue how so many of our services and day to day functions rely on being online.  I do not have internet in my flat.  Any half decent connection requires a land line, which I also do not have.  So I would have to pay line rental and then broadband costs on top of that.  I live on benefits, which gives me a rather limited budget and Wi-Fi in my flat would eat a significant chunk of that budget every month.  I have managed by using phone data or Wi-Fi elsewhere, but society seems to revolve around the assumption everyone has good internet access.  Job searching requires internet, as does applying for benefits, which means people out of work have to find a way online.  I suspect this contributes to a significant number of people ending up in debt, having expensive phone contracts or taking out loans to pay for broadband. 

News articles come up fairly regularly about internet access and the government role out of broadband so everyone is connected even in rural areas.  They often mention internet speeds, but they hardly ever mention cost.  They talk as if broadband is free, when in fact it can be pretty expensive.  They can install as many fibre-optic broadband cables as they like, but without the means to pay for it or find it elsewhere it is always going to be hard for some people to get online.      

It was not so bad when every town had libraries with computer access to get online, but libraries have now had significant budget cuts and some have reduced opening hours a lot or closed altogether.  When I was on job seekers benefit, the staff at the job centre told us to use the library to get online if we had no internet at home, but if the opening hours are cut drastically there will be a higher demand for computers when they are open, meaning people may struggle to find a computer that is available.  Internet cafes are also increasingly rare now, with most cafes having free Wi-Fi instead, relying on you having a mobile phone or tablet to use it on.

Even if you have internet access it can go wrong and stop working.  On those occasions if you need to get in contact with someone it helps if you can still ring them or fill in a paper form instead.  However more and more companies and services seem to be online only now.  A lot of offices are now going paper free, with the claim that is to save the environment and to make accessing things like files and forms easier.  This is especially the case with a lot of government services such as applying for benefits and housing.  This can work very well, till you find you have no way to get online!

There are charities who try to help with internet access with free computer use or helping you to fill a form in online.  However the computer use is often limited to what the charity is set up to support with, such as a housing charity only letting you on housing based support sites.  My local council have free computer access in reception, but the computers are locked to certain websites such as the DWP to apply for benefits, Devon Home Choice to apply for housing, CAB charity and that kind of thing. 

Another issue can be the equipment you access the internet on.  Be it by laptop, tablet, phone or PC, they all have the potential to go wrong and break down.  Some seem to only last a few years before they die altogether or need upgrading to work with current apps and certain websites.  It is hard to keep upgrading your electronics on a budget.  I am lucky that I got my latest phone as a part birthday gift from my family with me paying for some of it myself.  Not everyone is this lucky.  The poorest people, unless they want to end up in debt can be priced out of an increasingly paperless society.

Pedestrians and Roads

Image result for road crossing disabled

A lot of disabled and more vulnerable people do not drive.  This can be due to being physically unable to, learning difficulties or costs.  I cannot drive, so chose to live in a small town where most things are walking distance and the public transport links are good.  However as a pedestrian I often feel that walking is less safe than it should be when it comes to roads.

Crossing the road can be very tricky at times.  Some drivers seem to drive like they are the only people in the world that matter or that no one else could possibly exist outside their own car, at least that is how it can seem at times to me.  Some drivers act as if the rules of the road are there to pick and choose from as they like, that or they forget some of the rules as soon as they pass their test.  I am careful when crossing the road, looking both ways and waiting till it is clear.  Although it does not matter how careful I am if a car comes careering around the corner without slowing down when I have already started to cross.  I can dash out of the way if I need to and step back, but for some this is much harder.  Some people with mobility issues can struggle to get out of the way in time.

I can decide it is safe to cross as the car is clearly going the other way, but then it turns out they are coming my way, they just did not indicate.  An awful lot of drivers do not indicate at turnings.  On very busy roads this is a problem as I can wait a very long time for there to be no cars at all and it would help to know I can cross when cars are going the other way.  I am sure other drivers would also appreciate if other cars indicated as they should.

Where possible I will use a crossing such as a zebra or pelican crossing, as it usually makes crossing the road far safer.  Most drivers are good at stopping for them if someone is waiting, but I have known drivers to ignore crossings, especially zebra crossings.  This is rude and dangerous.  I also do not like drivers who creep up closer and closer to me at crossings as if to get me to hurry up and walk faster.   I may be walking as fast as I can already, since I get days when my leg muscles are more stiff around my false hip and lots of people struggle with walking fast.

Road side parking is also an issue drivers need to consider with pedestrians in mind.  Parking on the pavement can be a serious problem for some disabled people.  I am able to walk around a car, either by squeezing past it, or by walking onto the road, but a lot of people cannot do this.  Wheelchairs, mobility scooters and walking frames can make it impossible to get past a car or anything blocking the pavement.  When it is a busy road I dislike having to walk on it and some less able people find it very scary.  Parking in front of drop down curbs can also prevent some disabled people from getting to their destination.  When a driver says ‘I’m only going to be five minuets’, that is no excuse.  That five minutes might make the disabled person late for an appointment or miss the bus.  Anyway, why should they have to wait for you?

I do not totally blame drivers; some roads are poorly designed for the pedestrian.  It can seem on some roads as if adding a pavement was an afterthought and the need to cross the road never even occurred to the planners.  In my town there is a road I often need to cross that has four directions a vehicle can come from and I cannot even see one of the directions clearly.  Then there are roads where the pavement just runs, so if you do not know the road you can end up in a very difficult situation.

Another issue planners often fail to think about is adding any kind of walkway in car parks.  Having to cross a car park on foot can be hazardous with drivers not always fully paying attention yet, doing up seat belts or setting sat-nav.  Even at 5mph being hit by a car hurts.  There are quite a few places that have car park right in front of them that you have to cross in order to get to them, often railway stations.  Having been hit by a car in a railway station car park, I know I am lucky that I only got bruising to my leg, but some disabled people might not come off so lightly.

Some pedestrians could help themselves more.  I have often seen people cross down the road from a proper crossing just to save walking a few extra yards, even on very busy, fast roads.  Some people have music on far too loudly in their headphones preventing them from hearing oncoming traffic.  On some roads you can hear traffic before you can see it.  Pedestrians need to pay attention when walking by roads and especially when crossing.

Drivers need to pay attention to what is going on around them outside of their vehicle.  This includes in car parks and places you may not expect to see a pedestrian.  Drivers need to think when parking, can a wheelchair get past?  Is there a drop down curb I might be blocking?  It is important to remember a lot of less able people walk and need to get where they are going safely.

Friends & Friendship

I would not describe myself as popular and do not think I ever have been, but I have more friends now than I used to.  It took me a very long time to meet so many people I would call true friends.  People I know I can share with honestly and openly, who I trust will not judge me and at least try to understand me.  I know that when it comes to friendship it is quality over quantity, better to have a few loyal friends, than lots of people who are only there in the good times, and let you down when things are not going so well.

I remember struggling to make friends when younger.  As a child I had phases of having a few friends and phases of not really having any at all.  I remember not fitting in very well with others at school and spending a lot of time on my own during break.  At primary school I did not always mind having so few friends as I enjoyed my own company and could often amuse myself.  However by the time I went to secondary school I was feeling increasingly lonely.  I was bullied to the point I would often refuse to go to go to school.  I knew by this point that I was somewhat different to my peers.  At the age of twelve I was diagnosed as having Obsessive Compulsive Disorder, which went some way to explain my social life or lack of, but as a teenager I realised there was more to my issues than just OCD.  However I had no idea what I could do about it.  For a lot of my teens I had very few friends.  I did not really fit into any social groups.  At times it really upset me to not be invited to things and be left out of social events, but sometimes I minded less and I suppose I got sort of used to not having many friends.

During my first two college courses I did not make any friends.  I got on OK with some people, but could not say they were really friends.  When I started a performing arts course I got on somewhat better with people.  We had a common interest in theatre and performing.  Drama people are often the outsiders, the ones who did not get on so well in school and tend to be a bit different.  Also performers tend to get good at reading people and understanding them better having to work so closely together.  I did not get invited out much, but back then I did not drink alcohol and I think some of my class knew I would not have enjoyed a drunken pub crawl or nightclubs much anyway.  Over my three years of performing arts at college I got slightly better at socialising between classes.  I did get invited to a couple of parties and had a twenty-first birthday party myself.

At twenty-three I went away to university.  I felt I fitted in and got on with people there a lot more than I had anywhere else.  By the time I left university I felt I had made some real friends.  I think partly it was having common interests, but also I was more mature and had learnt how to socialise a bit better.  I had started drinking by this point and enjoyed going to pubs and clubs more.  (Although I was not really a heavy drinker compared to a lot of students and did not go to night clubs very often.)

Since moving out of my parent’s house and living more independently I have made more friends and gained more of a social life.  It helps that I understand myself somewhat better now, having finally had a proper autism diagnoses and have taken time to learn more about my conditions.  I am less angry and confused about who I am, which helps how I come across to others.  I feel calmer and have less public meltdowns.  Although I still have the occasional outburst, they do not last as long and I get over them more quickly.  Also I have learnt the kind of people who I tend to get on better with and will make more suitable long term friends for me.  I have found that when it comes to making friends age and sex does not matter so much as understanding.  People who can accept my autism and OCD and do not judge me based on my conditions.

I have had one really good friend throughout the years that I have known for longer than anyone else, since I was in my early teens in fact.  I really appreciate this friendship because this person has been there for so long and always supported me even when things in my life were not going so well, and I had no other friends.  It showed me that I could make real friends if I made the effort and it was worth doing so.

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